What Are the
Types of Learning Disabilities?
"Learning disability"
is not a diagnosis in the same sense as "chickenpox"
or "mumps." Chickenpox and mumps imply a single, known
cause with a predictable set of symptoms. Rather, LD is a broad
term that covers a pool of possible causes, symptoms, treatments,
and outcomes. Partly because learning disabilities can show up
in so many forms, it is difficult to diagnose or to pinpoint the
causes. And no one knows of a pill or remedy that will cure them.
Not all learning problems are necessarily learning disabilities.
Many children are simply slower in developing certain skills.
Because children show natural differences in their rate of development,
sometimes what seems to be a learning disability may simply be
a delay in maturation. To be diagnosed as a learning disability,
specific criteria must be met.
The criteria and characteristics for diagnosing
learning disabilities appear in a reference book called the DSM
(short for the Diagnostic and Statistical Manual of Mental Disorders).
The DSM diagnosis is commonly used when applying for health insurance
coverage of diagnostic and treatment services.
Learning disabilities can be divided into three
broad categories:
Developmental speech and language disorders
Academic skills disorders
"Other," a catch-all that includes certain coordination
disorders and learning handicaps not covered by the other terms
Each of these categories includes a number of
more specific disorders.
Developmental Speech and Language Disorders
Speech and language problems are often the earliest
indicators of a learning disability. People with developmental
speech and language disorders have difficulty producing speech
sounds, using spoken language to communicate, or understanding
what other people say. Depending on the problem, the specific
diagnosis may be:
Developmental articulation disorder
Developmental expressive language disorder
Developmental receptive language disorder
Developmental Articulation Disorder -- Children
with this disorder may have trouble controlling their rate of
speech. Or they may lag behind playmates in learning to make speech
sounds. For example, Wallace at age 6 still said "wabbit"
instead of "rabbit" and "thwim" for "swim."
Developmental articulation disorders are common. They appear in
at least 10 percent of children younger than age 8. Fortunately,
articulation disorders can often be outgrown or successfully treated
with speech therapy.
Developmental Expressive Language Disorder --
Some children with language impairments have problems expressing
themselves in speech. Their disorder is called, therefore, a developmental
expressive language disorder. Susan, who often calls objects by
the wrong names, has an expressive language disorder. Of course,
an expressive language disorder can take other forms. A 4-year-old
who speaks only in two-word phrases and a 6-year-old who can't
answer simple questions also have an expressive language disability.
Developmental Receptive Language Disorder -- Some
people have trouble understanding certain aspects of speech. It's
as if their brains are set to a different frequency and the reception
is poor. There's the toddler who doesn't respond to his name,
a preschooler who hands you a bell when you asked for a ball,
or the worker who consistently can't follow simple directions.
Their hearing is fine, but they can't make sense of certain sounds,
words, or sentences they hear. They may even seem inattentive.
These people have a receptive language disorder. Because using
and understanding speech are strongly related, many people with
receptive language disorders also have an expressive language
disability.
Of course, in preschoolers, some misuse of sounds,
words, or grammar is a normal part of learning to speak. It's
only when these problems persist that there is any cause for concern.
Academic Skills Disorders
Students with academic skills disorders are often
years behind their classmates in developing reading, writing,
or arithmetic skills. The diagnoses in this category include:
Developmental reading disorder
Developmental writing disorder
Developmental arithmetic disorder
Developmental Reading Disorder -- This type of
disorder, also known as dyslexia, is quite widespread. In fact,
reading disabilities affect 2 to 8 percent of elementary school
children.
When you think of what is involved in the "three
R's"--reading, 'riting, and 'rithmetic--it's astounding that
most of us do learn them. Consider that to read, you must simultaneously:
Focus attention on the printed marks and control
eye movements across the page
Recognize the sounds associated with letters
Understand words and grammar
Build ideas and images
Compare new ideas to what you already know
Store ideas in memory
Such mental juggling requires a rich, intact network
of nerve cells that connect the brain's centers of vision, language,
and memory.
A person can have problems in any of the tasks
involved in reading. However, scientists found that a significant
number of people with dyslexia share an inability to distinguish
or separate the sounds in spoken words. Dennis, for example, can't
identify the word "bat" by sounding out the individual
letters, b-a-t. Other children with dyslexia may have trouble
with rhyming games, such as rhyming "cat" with "bat."
Yet scientists have found these skills fundamental to learning
to read. Fortunately, remedial reading specialists have developed
techniques that can help many children with dyslexia acquire these
skills.
However, there is more to reading than recognizing
words. If the brain is unable to form images or relate new ideas
to those stored in memory, the reader can't understand or remember
the new concepts. So other types of reading disabilities can appear
in the upper grades when the focus of reading shifts from word
identification to comprehension.
Developmental Writing Disorder -- Writing, too,
involves several brain areas and functions. The brain networks
for vocabulary, grammar, hand movement, and memory must all be
in good working order. So a developmental writing disorder may
result from problems in any of these areas. For example, Dennis,
who was unable to distinguish the sequence of sounds in a word,
had problems with spelling. A child with a writing disability,
particularly an expressive language disorder, might be unable
to compose complete, grammatical sentences.
Developmental Arithmetic Disorder -- If you doubt
that arithmetic is a complex process, think of the steps you take
to solve this simple problem: 25 divided by 3 equals ?
Arithmetic involves recognizing numbers and symbols,
memorizing facts such as the multiplication table, aligning numbers,
and understanding abstract concepts like place value and fractions.
Any of these may be difficult for children with developmental
arithmetic disorders. Problems with numbers or basic concepts
are likely to show up early. Disabilities that appear in the later
grades are more often tied to problems in reasoning.
Many aspects of speaking, listening, reading,
writing, and arithmetic overlap and build on the same brain capabilities.
So it's not surprising that people can be diagnosed as having
more than one area of learning disability. For example, the ability
to understand language underlies learning speak. Therefore, any
disorder that hinders the ability to understand language will
also interfere with the development of speech, which in turn hinders
learning to read and write. A single gap in the brain's operation
can disrupt many types of activity.
"Other" Learning Disabilities
The DSM also lists additional categories, such
as "motor skills disorders" and "specific developmental
disorders not otherwise specified." These diagnoses include
delays in acquiring language, academic, and motor skills that
can affect the ability to learn, but do not meet the criteria
for a specific learning disability. Also included are coordination
disorders that can lead to poor penmanship, as well as certain
spelling and memory disorders.
Attention Disorders
Nearly 4 million school-age children have learning
disabilities. Of these, at least 20 percent have a type of disorder
that leaves them unable to focus their attention.
Some children and adults who have attention disorders appear to
daydream excessively. And once you get their attention, they're
often easily distracted. Susan, for example, tends to mentally
drift off into a world of her own. Children like Susan may have
a number of learning difficulties. If, like Susan, they are quiet
and don't cause problems, their problems may go unnoticed. They
may be passed along from grade to grade, without getting the special
assistance they need.
In a large proportion of affected children--mostly
boys--the attention deficit is accompanied by hyperactivity. Dennis
is an example of a person with attention deficit hyperactivity
disorder--ADHD. They act impulsively, running into traffic or
toppling desks. Like young Dennis, who jumped on the sofa to exhaustion,
hyperactive children can't sit still. They blurt out answers and
interrupt. In games, they can't wait their turn. These children's
problems are usually hard to miss. Because of their constant motion
and explosive energy, hyperactive children often get into trouble
with parents, teachers, and peers.
By adolescence, physical hyperactivity usually
subsides into fidgeting and restlessness. But the problems with
attention and concentration often continue into adulthood. At
work, adults with ADHD often have trouble organizing tasks or
completing their work. They don't seem to listen to or follow
directions. Their work may be messy and appear careless.
Attention disorders, with or without hyperactivity,
are not considered learning disabilities in themselves. However,
because attention problems can seriously interfere with school
performance, they often accompany academic skills disorders.